Defense Date
2024
Document Type
Directed Research Project
First Advisor
Dr. Carl Wolf
Second Advisor
Dr. Michelle Peace
Third Advisor
Justin Poklis
Abstract
This research investigates the safety and reliability of blood donations by examining the presence of ethanol and phosphatidylethanol (PEth) in packed red blood cells (pRBCs). As blood donation is integral to healthcare, ensuring the safety of blood products is paramount. Current protocols focus on screening for infectious diseases, such as hepatitis C and human immunodeficiency virus (HIV), but do not routinely asses alcohol consumption, which can significantly impact patient outcomes. As a direct indicator of alcohol consumption, ethanol can affect blood quality, interfere with medical treatments, and present legal issues, such as false conclusions or assumptions. Ethanol detection methods include direct measurement and biomarker analysis, each presenting unique advantages and limitations.
This study specifically explores both methods within the context of pRBCs to enhance blood safety, donor screening, and forensic investigations. Direct ethanol measurement offers immediate results through techniques like headspace gas chromatography (HS-GC) but has a limited detection window due to ethanol’s half-life of 4-5 hours, making it less effective for identifying latent alcohol use. In contrast, PEth serves as a reliable and specific direct biomarker that indicates ethanol consumption over a more extended period of several weeks.
This thesis details the analysis of 1,237 pRBC samples for ethanol content using HS-GC with flame ionization detection (FID), revealing a positivity rate of 0.57%, with seven samples testing positive for ethanol concentrations above the established cutoff of 0.005 g/dL. Additionally, 240 pRBC segments were tested for the two most abundant homologues of PEth (16:0/18:1 and 16:0/18:2) using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), with 41.3% exceeding the clinically relevant threshold of 20 ng/mL and 22.5% exceeding 100 ng/mL. These results highlight a much higher likelihood of detecting alcohol use through PEth analysis compared to direct ethanol measurement.
The findings of this study underscores the limitations of direct ethanol detection in identifying latent alcohol consumption and the importance of biomarker analysis in enhancing the safety of the blood supply. PEth serves as a more reliable indicator of latent alcohol use, offering a broader scope for detecting alcohol exposure over time. By employing both HS-GC for ethanol and UPLC-MS/MS for PEth, this research contributes to the growing body of knowledge on blood donor screening and offers valuable insights for improving clinical and forensic practices related to blood safety.
Rights
© The Author(s)
Is Part Of
VCU Master of Science in Forensic Science Directed Research Projects
Date of Submission
12-16-2024